Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
DILT-CD vs CADUET
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Diltiazem inhibits calcium ion influx during depolarization of cardiac and vascular smooth muscle cells, thereby reducing intracellular calcium levels. It decreases sinoatrial and atrioventricular nodal conduction and dilates coronary and peripheral arteries.
Amlodipine: Dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral vascular resistance. Atorvastatin: HMG-Co A reductase inhibitor that competitively inhibits the conversion of HMG-Co A to mevalonate, reducing cholesterol synthesis in the liver.
Hypertension,Chronic stable angina,Variant angina,Atrial fibrillation or atrial flutter (rate control),Paroxysmal supraventricular tachycardia
Hypertension,Coronary artery disease,Hyperlipidemia (as adjunct to diet to reduce elevated total-C, LDL-C, apo B, and TG levels, and to increase HDL-C),Prevention of cardiovascular events in patients with multiple risk factors
180-360 mg PO once daily (extended-release); 300-540 mg PO once daily for hypertension; 120-480 mg PO once daily for angina; IV: 0.25 mg/kg bolus over 2 min, then 5-15 mg/hr continuous infusion.
CADUET (amlodipine/atorvastatin) is available as tablets of 2.5/10, 2.5/20, 2.5/40, 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40, and 10/80 mg amlodipine/atorvastatin. Initial dose depends on current antihypertensive and lipid-lowering therapy. Usual starting dose is 5/10 mg orally once daily; titrate at intervals of 2-4 weeks based on blood pressure and LDL-C goals. Maximum daily dose: amlodipine 10 mg; atorvastatin 80 mg.
Terminal elimination half-life 7-10 hours; clinically relevant in hepatic impairment (prolonged to 14-20 hours) and in elderly
Amlodipine: terminal half-life 30-50 h (enables once-daily dosing). Atorvastatin: terminal half-life ~14 h, but active metabolites (ortho- and para-hydroxy atorvastatin) have half-life 20-30 h; clinically, pharmacodynamic half-life (HMG-Co A reductase inhibition) is ~20-30 h.
Hepatic via CYP3A4; undergoes deacetylation and N-demethylation.
Amlodipine: Extensively metabolized in the liver via CYP3A4 to inactive metabolites. Atorvastatin: Metabolized in the liver primarily by CYP3A4 to active ortho- and para-hydroxylated metabolites.
Renal 2-4% unchanged; extensive hepatic metabolism; 60-70% fecal, 30-40% renal as metabolites
Amlodipine: 60% renal (metabolites), 20-25% biliary/fecal. Atorvastatin: 1% renal (unchanged), 90% biliary/fecal (≥70% as metabolites).
85-90% bound to plasma proteins (primarily albumin and alpha-1-acid glycoprotein)
Amlodipine: ~93% bound to plasma proteins. Atorvastatin: ≥98% bound to plasma proteins (mainly albumin).
3-5 L/kg; large Vd indicates extensive tissue binding, with highest concentrations in liver, lung, and spleen
Amlodipine: Vd ~21 L/kg (large, indicating extensive tissue distribution). Atorvastatin: Vd ~6.2 L/kg (moderately large, suggesting distribution into tissues).
Oral immediate-release: 40-60% (first-pass effect); oral sustained-release: 30-50%; IV: 100%
Oral: amlodipine 64-90%; atorvastatin ~14% (low due to first-pass metabolism); food reduces rate but not extent of absorption.
No dosage adjustment required for mild-moderate renal impairment; use caution and consider dose reduction in severe renal impairment (Cr Cl <30 m L/min) due to potential accumulation.
No dosage adjustment required for mild to moderate renal impairment (Cr Cl ≥30 m L/min). For severe renal impairment (Cr Cl <30 m L/min), use atorvastatin with caution; maximum atorvastatin dose is 20 mg daily. Amlodipine is not dialyzable.
Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 25-50%; Child-Pugh C: contraindicated or use with extreme caution, reduce dose by at least 50%.
Contraindicated in active liver disease or unexplained persistent elevations of serum transaminases. For Child-Pugh Class A or B hepatic impairment: atorvastatin dose should be reduced; maximum atorvastatin dose is 20 mg daily. Amlodipine clearance is decreased; initial amlodipine dose should be 2.5 mg daily. No data for Child-Pugh Class C; use contraindicated.
Not FDA-approved for pediatric use; off-label dosing for hypertension: extended-release initial 2.5-5 mg/kg/day PO once daily, max 10 mg/kg/day up to 360 mg daily; for supraventricular tachycardia: IV bolus 0.1-0.3 mg/kg over 2 min, may repeat after 30 min, max 10 mg/dose.
Not recommended for pediatric patients. Safety and efficacy in children <10 years have not been established. For patients 10-17 years with heterozygous familial hypercholesterolemia, atorvastatin monotherapy is used; CADUET is not indicated.
Start at lower end of dosing range (e.g., 120 mg PO once daily for hypertension); titrate slowly; monitor for hypotension, bradycardia, and constipation; consider reduced initial dose due to altered pharmacokinetics.
Elderly patients (≥65 years) may have increased sensitivity to amlodipine; start at the lower end of dosing range (2.5 mg amlodipine component). Atorvastatin dose adjustment not required based on age alone. Monitor for hypotension and other adverse effects.
None.
HMG-Co A reductase inhibitors (statins) can cause fetal harm; use in pregnant women is contraindicated. Caduet contains atorvastatin; therefore, it is contraindicated in pregnant women.
May cause bradycardia, heart block, or heart failure exacerbation,Use caution in patients with impaired left ventricular function,May cause hypotension, especially in patients with aortic stenosis,May increase digoxin and cyclosporine levels,Abrupt withdrawal may exacerbate angina,Hepatic impairment may require dose adjustment,Avoid use in patients with sick sinus syndrome or second/third-degree AV block without pacemaker
Myopathy/Rhabdomyolysis: Risk increased with higher doses, age >65, renal impairment, hypothyroidism, and concurrent use of CYP3A4 inhibitors or other drugs that cause myopathy.,Hepatic effects: Elevated liver enzymes; perform liver function tests before initiation and as clinically indicated.,Fetal toxicity: May cause fetal harm; advise females of reproductive age to use effective contraception.,Peripheral edema: More common with higher doses of amlodipine, especially in females.,Hypotension: In patients with severe aortic stenosis.
Sick sinus syndrome (except with functioning pacemaker),Second- or third-degree AV block (except with pacemaker),Hypotension (systolic <90 mm Hg),Acute myocardial infarction with pulmonary congestion,Known hypersensitivity to diltiazem,Concomitant use with dantrolene (risk of ventricular fibrillation),Concurrent use with ivabradine
Active liver disease or unexplained persistent elevations of hepatic transaminases,Pregnancy,Breastfeeding (due to potential for serious adverse reactions in nursing infants),Hypersensitivity to amlodipine, atorvastatin, or any component of the formulation
Avoid grapefruit and grapefruit juice; they inhibit CYP3A4 and increase diltiazem levels, raising risk of toxicity. High-fat meals may increase absorption; take with food to reduce gastrointestinal upset. Alcohol may enhance hypotension and dizziness; limit consumption.
Avoid grapefruit and grapefruit juice as they increase atorvastatin plasma concentrations and risk of adverse effects. No significant food interactions with amlodipine.
DILT-CD is a formulation of diltiazem, a calcium channel blocker. In animal studies, diltiazem has been associated with fetal skeletal abnormalities and reduced fetal weight at high doses. Human data are limited; however, diltiazem is generally avoided in the first trimester due to potential teratogenic effects. In the second and third trimesters, use is cautioned due to risks of maternal hypotension and possible fetal hypoxia. Diltiazem crosses the placenta and may cause fetal bradycardia.
FDA Pregnancy Category X. Amlodipine: No evidence of teratogenicity in animal studies, but limited human data; atorvastatin: contraindicated in pregnancy as HMG-Co A reductase inhibitors are associated with fetal abnormalities, including skeletal and CNS defects. First trimester: Atorvastatin is contraindicated; risk of congenital anomalies. Second/third trimester: Avoid exposure; potential for fetal toxicity. Effective contraception required for women of childbearing potential.
Diltiazem is excreted into breast milk in small amounts; the estimated infant dose is approximately 1% of the maternal weight-adjusted dose. The milk-to-plasma ratio (M/P) is reported as 0.5-1.0. Caution is advised due to potential cardiovascular effects in the nursing infant, though limited data suggest low risk. Monitor infant for bradycardia and hypotension.
Excreted in human milk: Amlodipine: present in low levels (M/P ratio approximately 1.0); atorvastatin: unknown. Due to potential for serious adverse reactions in nursing infants (e.g., skeletal muscle toxicity from statins), breastfeeding is contraindicated during therapy. Alternative agents preferred.
Pregnancy may increase diltiazem clearance due to expanded plasma volume and enhanced hepatic metabolism. Dose adjustments may be needed to maintain efficacy; however, specific pharmacokinetic studies for DILT-CD are lacking. Generally, use the lowest effective dose and monitor clinical response. Titrate based on maternal blood pressure and heart rate.
Contraindicated during pregnancy; therefore, no dosing adjustments recommended. Discontinue therapy immediately if pregnancy is suspected or confirmed. Pharmacokinetic changes during pregnancy may alter drug metabolism, but no dose adjustments are justified due to teratogenic risk.
DILT-CD is a calcium channel blocker (non-dihydropyridine) used for hypertension and angina. It has negative chronotropic and dromotropic effects; avoid in patients with sick sinus syndrome or second/third-degree AV block without a pacemaker. Monitor heart rate and PR interval. May increase digoxin levels; co-administration requires dose adjustment. Contraindicated with IV beta-blockers due to risk of bradycardia and heart failure.
CADUET is a fixed-dose combination of amlodipine (a calcium channel blocker) and atorvastatin (a statin) used for hypertension and dyslipidemia. Avoid concomitant use with strong CYP3A4 inhibitors (e.g., clarithromycin, itraconazole) due to increased statin exposure and risk of myopathy. Monitor liver enzymes before and during therapy, and for muscle symptoms. Use with caution in patients with severe renal impairment. Avoid grapefruit juice as it increases atorvastatin levels.
Take exactly as prescribed; do not crush or chew extended-release capsules.,May cause dizziness or lightheadedness; avoid driving until you know how this medication affects you.,Report slow heartbeat, shortness of breath, or swelling in your ankles or feet.,Limit alcohol intake as it may increase side effects.,Avoid grapefruit and grapefruit juice as they can increase drug levels and side effects.
Take this medication once daily at the same time, with or without food.,Avoid grapefruit and grapefruit juice while taking this medication.,Report unexplained muscle pain, tenderness, or weakness, especially if accompanied by fever or malaise.,Notify your doctor if you become pregnant, plan to become pregnant, or are breastfeeding.,Do not stop taking this medication without consulting your doctor, even if you feel well.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about DILT-CD vs CADUET, answered by our medical review team.
DILT-CD is a Calcium Channel Blocker that works by Diltiazem inhibits calcium ion influx during depolarization of cardiac and vascular smooth muscle cells, thereby reducing intracellular calcium levels. It decreases sinoatrial and atrioventricular nodal conduction and dilates coronary and peripheral arteries.. CADUET is a Calcium Channel Blocker + HMG-CoA Reductase Inhibitor that works by Amlodipine: Dihydropyridine calcium channel blocker that inhibits calcium ion influx across cardiac and vascular smooth muscle cell membranes, causing vasodilation and reduced peripheral vascular resistance. Atorvastatin: HMG-Co A reductase inhibitor that competitively inhibits the conversion of HMG-Co A to mevalonate, reducing cholesterol synthesis in the liver.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between DILT-CD and CADUET depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of DILT-CD is: 180-360 mg PO once daily (extended-release); 300-540 mg PO once daily for hypertension; 120-480 mg PO once daily for angina; IV: 0.25 mg/kg bolus over 2 min, then 5-15 mg/hr continuous infusion.. The standard adult dose of CADUET is: CADUET (amlodipine/atorvastatin) is available as tablets of 2.5/10, 2.5/20, 2.5/40, 5/10, 5/20, 5/40, 5/80, 10/10, 10/20, 10/40, and 10/80 mg amlodipine/atorvastatin. Initial dose depends on current antihypertensive and lipid-lowering therapy. Usual starting dose is 5/10 mg orally once daily; titrate at intervals of 2-4 weeks based on blood pressure and LDL-C goals. Maximum daily dose: amlodipine 10 mg; atorvastatin 80 mg.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between DILT-CD and CADUET in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. DILT-CD is classified as Category C. DILT-CD is a formulation of diltiazem, a calcium channel blocker. In animal studies, diltiazem has been associated with fetal skeletal abnormalities and reduced fetal weight at hig. CADUET is classified as Category C. FDA Pregnancy Category X. Amlodipine: No evidence of teratogenicity in animal studies, but limited human data; atorvastatin: contraindicated in pregnancy as HMG-CoA reductase inhib. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.